Woman finds new potential after surgery

Laura Shockey, Friedens, was having fun going down the natural rock water slide in Linn Run State Park near Ligonier in August 1997, when she went down it head first.

"I hit my head against a rock and the area above my right eye swelled instantly," she said. "I didn't lose consciousness. I didn't have a concussion. I didn't even go see a doctor. I thought nothing was wrong."

Unknown to Laura, she had suffered a brain injury. Six months later, her mother, Paulette, who is a nurse, went in to her room one morning to wake her and realized Laura was having a grand mal seizure. Physicians started treating Laura with anti-seizure medication.

"The seizures were controlled, but I would space-out," she said. "I was conscious, but I would chew my tongue and groan. I was nauseated and at times the seizures gave me headaches and I would always get really tired. I would understand what people said and I would respond, but later, I wouldn't remember anything."

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Soon after the episodes began, her father, Dale, began having heart trouble. He needed a quadruple bypass. They thought Laura, the youngest of the Shockeys' four daughters, was under stress because of her father's hospitalization. He died in October 1999.

"My seizures continued, I'd have three or four a day for two or three days," Laura said. "Then maybe I'd go for two or three weeks without any and then they'd start up again. The medication wasn't doing enough. I just couldn't stand it anymore."

Because of her seizures, Laura had difficulty being independent and wasn't allowed to drive.

She went to see Dr. Kevin Kelly, a neurologist at Allegheny General Hospital in Pittsburgh in summer 2003. He immediately diagnosed it as complex partial seizures.

Complex partial seizures usually start in a small area of the brain's temporal lobe or frontal lobe. They involve other areas of the brain that affect alertness and awareness. Even though the person's eyes are open and they may make movements, in reality "nobody's home," according to the Web site epilepsy.com.

Kelly told them Laura could be a candidate for neurosurgery. A temporal lobectomy is one of the most commonly performed surgical operations for intractable epilepsy. It involves the removal of brain structures known as the hippocampus and amygdala located in the deep part of the temporal lobes of the brain.

"As soon as I heard about it, I said I want this now, let's do it today," Laura said. "My mom thought no. I said Dad had quadrupled bypass surgery. She replied that his was life-threatening, mine wasn't. I said this is affecting my life. Dr. Kelly said first, there are different tests to find out if I was even a candidate."

She began reading more about the procedure and started having the tests.

"The medication was not working," she said. "Through prayer, I knew this was the right thing for me."

Dr. Jack Wilberger, chairman of the Department of Neurosurgery at Allegheny General Hospital, said in a telephone interview surgery for epilepsy is one of the first neurosurgery procedures developed. Back in the 1800s, a person was kicked in the head by a horse. He began to have seizures and surgeons removed the depressed bone. The seizures stopped. They realized the connection between brain damage and seizures.

When anti-seizure medications were developed starting in the 1950s, the surgery dropped off because it was thought that medication was the better option. But medication doesn't work for everyone.

"Surgery is being done earlier and earlier," Wilberger said. "We've realized the bad effect seizures have on life. Kids in school either can't go to school or can't learn well when they are having frequent seizures. Then there are the social problems. We've realized if people don't respond well to two or three medications, the likelihood is they won't respond to any medication. So we are turning to surgery sooner."

The highest success rate for the surgery is when the seizures are caused by the temporal lobe, he said. People who have that surgery have about a 70 percent success rate. If the seizures are being caused by another area of the brain, the rate goes down to 50 percent and for some with extremely severe disorders, it drops to a 20 to 30 percent success rate.

"Our goal is to make sure we know exactly where the seizures are coming from and if the risk will be minimal," he said. "Then, it is up to the patient to decide. Only the patient knows if it is worth surgery."

One patient of his had only one seizure. But he was an international pilot and couldn't fly, so his livelihood was endangered. The surgery was successful. At the other extreme, he has known of patients who have 15 to 20 seizures a week who don't want surgery.